Vestibular paroxysmia is believed to be caused by the neurovascular compression of the cochleovestibular nerve, as it occurs with other neurovascular compression syndromes (. trigeminal neuralgia). The irregular and unpredictable spells are the most disabling aspect of this condition, making some daily activities, like driving, extremely dangerous. In theory, given its pathophysiology, surgical treatment could be considered. Still, due to the substantial surgical risks involved, this approach is reserved for particular cases where pharmacological treatment is not effective or tolerated. Treatment with carbamazepine (Tegretol®) or oxcarbamazepine (Trileptal®), both anticonvulsants primarily used in the treatment of epilepsy, is usually not only effective in small dosages, but is also diagnostic. Vestibular depressants are not effective.
Growing dogs require greater amounts of protein, calories, vitamins and minerals (particularly calcium). Puppies often double their weight in a short time. Animal protein sources are best for growing dogs (beef, lamb, fish, eggs, poultry). It’s important to weigh your dog throughout the first 12 months to check if the weight is normal - you need to know the full adult weight for the breed (estimate mixed breeds). For example, if you know your dog will weigh 50 pounds when full grown, then at 6 months she should weigh 30 pounds you can adjust the diet accordingly.
There are a number of causes of vestibular disease in dogs. Sometimes we can’t identify a cause, and then the condition is termed “idiopathic”. Other times the cause can be identified, and could be due to hypothyroidism, a middle or inner ear problem, a small cerebral infarct (stroke) or even a tumor. I would recommend that you contact your veterinarian and report that your dog is still showing these vestibular signs. If the dog has not been checked for hypothyroidism or other potential causes, I would recommend doing that. For some dogs with idiopathic vestibular disease, it may take more than two week for all the signs to resolve. In others, it’s a matter of a few days. Each one is different. Good luck to you and your dog!